NEW YORK – An Indian-origin cardiologist and the administrator of her company have agreed to pay $400,000 to settle allegations that they submitted irregular billings to Medicare, the government health insurance programme for senior citizens, according to officials.
Southern Texas federal prosecutor Ryan Patrick said on Wednesday that cardiologist Annie Varughese, 57, who owned the Houston-based company, and its administrator, Babu Varughese, 64, agreed to the payment to resolve allegations that they violated the False Claims Act (FCA).
The allegations came to light when a former cardiologist filed a lawsuit under FCA that allows whistleblowers to file cases on behalf of the government and be entitled to a share of the proceeds from the action, the prosecutor’s office said.
One of the allegations was that her company sent bills under her number to Medicare for services performed when she was not in the country.
Other allegations were that claims were sent to Medicare for services “that were not reasonable and medically necessary.” Federal Bureau of Investigation Special Agent in Charge Perrye Turner said, “Billing Medicare for services that are not necessary and/or not provided constitutes fraud.”
He added, “The largest area of fraud committed against the federal government today is by unethical healthcare providers who inflate or fabricate Medicare or Medicaid bills.”
Sometimes the government reaches an agreement for those facing allegations to settle out of court by making a payment or restitution in order to avoid costly or complicated litigation.
In this case, while making the settlement they have not made any admissions and, as the prosecutor’s office said, they are legally only allegations “with no determination of liability.”